When are chest X-ray scans performed in the emergency department useful?

Introduction

This study was designed to demonstrate use of chest X-ray scans in a district general hospital emergency department and to highlight areas of inappropriate use.

Methods

A retrospective chart review of 62 consecutive chest X-ray exposures from emergency patients in the department. The frequency of temperature, pulse, respiratory rate and oxygen saturation parameters were recorded, and those subsequently abnormal. The indication for the X-ray scan, information about previous chest X-ray scans and the record of the observed result were reviewed, as well as whether the patient's management was altered by the result of the X-ray scan.

Results

Only 50% of the X-ray scans provided information that would potentially change the patient's management, although 68% had positive findings recorded. Twenty-nine per cent were requested for investigation of chest pain (pleuritic in 8.1%), 11.3% for investigation of abdominal pain, and 5% for transient ischemic attacks.

Conclusion

Approximately 50% of chest X-ray scans requested from the emergency department are inappropriate. They are often requested unnecessarily for chest pain, transient ischaemic attacks, mild chest infections, head injury, haematemesis and minor injuries.